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  • Title: Segmental resection for the treatment of congenital pulmonary malformations.
    Author: Bagrodia N, Cassel S, Liao J, Pitcher G, Shilyansky J.
    Journal: J Pediatr Surg; 2014 Jun; 49(6):905-9. PubMed ID: 24888832.
    Abstract:
    PURPOSE: The purpose of this study was to compare clinical outcomes of segmental resection to lobectomy as increasing antenatal diagnosis of congenital pulmonary malformations has led to a shift in surgical management. METHODS: A retrospective institutional review for patients undergoing surgical excision of congenital pulmonary malformations was performed. RESULTS: Sixty-two patients with congenital pulmonary malformations were reviewed between 2001 and 2012. Forty-five were included for analysis. Malformations were subdivided into two groups, including congenital lobar emphysema (CLE) (n=11, 24%) and intrapulmonary (IP) lesions (n=34, 76%). Nineteen (56%) IP patients underwent segmental resection, and 15 (79%) were performed thoracoscopically without conversion to thoracotomy. None of these patients had recurrent disease. Lobectomy was performed in 11 (100%) CLE and 15 (44%) IP patients, and the majority were by thoracotomy. Median hospital stay was longer for the lobectomy group at 7days when compared to the segmentectomy group at 2days (p<0.001). There was not a difference in complication rate (21% vs. 19%, p=1.000) or in median number of chest tube days (2 vs. 3days, p=0.079) for segmentectomy versus lobectomy patients. CONCLUSIONS: Segmental resections of congenital pulmonary malformations can be performed safely while conserving healthy lung tissue.
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